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INORGANIC PHOSPHORUS
OSR6122 AND OSR6222
This procedure is valid for the following chemistry analyzers:
AU400/AU400e AU640/AU640e
AU480 AU680
AU600 AU2700
AU5400 AU5800
# of # of
Distributed to Copies Distributed to Copies
PRINCIPLE:
Measurements of inorganic phosphorus are used in the diagnosis and
treatment of various disorders including parathyroid gland and kidney
diseases, and vitamin D imbalance.
In 1925, Fiske and Subbarow1 described a method for the determination of
phosphorus in proteinfree blood filtrates using ammonium molybdate.
Aminoaphtholsulfonic acid was employed as a reducing agent. Many reducing
agents have since been introduced, among them ferrous sulfate (first
introduced by Summer2). This methodology offered the advantage of working
in a slightly acid medium, thereby permitting greater specificity in dealing
with mixtures of phosphates and phosphate esters. Taussky and Shorr 3 in
1953 improved the methodology by using ferrous ammonium sulfate, which is
more stable than ferrous sulfate. In 1957, Dryer, Tammes, and Routh4
increased the sensitivity of the reaction by measuring the absorbance at 340
nm rather than the previously recommended 650 to 750 nm.
INTENDED USE:
System reagent for the quantitative determination of Inorganic Phosphorus
in human serum or urine on Beckman Coulter AU Clinical Chemistry
analyzers.
METHODOLOGY:
The Beckman Coulter AU System Phosphorus method is based on a
modification of the method developed by Daly and Ertingshausen5 in which
inorganic phosphate reacts with molybdate to form a heteropolyacid complex.
The use of a surfactant eliminates the need to prepare a protein free filtrate.
The absorbance at 340/380 nm is directly proportional to the inorganic
phosphorus level in the sample.
Phosphate + Molybdate Heteropolyacid complex
SPECIMEN:
PATIENT PREPARATION:
A fasting serum specimen is recommended, but not required.
24hour specimen required for urine, acidify with HCl after collection.
Additional instructions for patient preparation as designated by this laboratory:
TYPE:
Serum samples free from hemolysis, are the recommended specimens.
Remove serum from clot as soon as possible to minimize hemolysis.
EDTA, fluoride oxalate or citrate should not be used when measuring
inorganic phosphorus.
Timed, 24hour collection is recommended for urine specimens. Urine
specimens should be manually prediluted 1:10 with water before analysis
on the AU600 Analyzer in Standard Measure Mode.
Please note that there is a diurnal variation in urine phosphate excretion,
with the highest output occurring in the afternoon. 6
Additional type conditions as designated by this laboratory:
HANDLING CONDITIONS:
Serum samples are stable up to 8hours when stored at room temperature
(15 25°C) or up to one week when stored refrigerated at 2 8°C.7
Urine may contain larger quantities of organic phosphates, which can decompose on exposure to elevated temperatures. When
acidified with HCl, urine phosphate is stable for more than 6 months.
8
Additional handling conditions as designated by this laboratory:
Beckman Coulter AU400/AU400e, AU480, AU600, AU640/AU640e,
AU680, AU2700, AU5400 and AU5800 analyzers.
MATERIALS:
Beckman Coulter AU System Inorganic Phosphorus Reagent
Final concentration of reactive ingredients:
Ammoniumheptamolybdate 0.35 mmol/L
Sulphuric acid 200 mmol/L
Glycine 50 mmol/L
Also contains preservatives.
Reagent storage location in this laboratory:
Test tubes 12 16 mm in diameter or sample cups (Cat No. AU1063).
Storage location of test tubes or sample cups in this laboratory:
Beckman Coulter Chemistry Calibrator (Cat. No. DR0070)
Beckman Coulter Urine Chemistry Calibrator (Cat. No. DR0090)
Storage location of the calibrator in this laboratory:
Precautions:
1. For in vitro diagnostic use.
2. WARNING! Corrosive, strong acid. Avoid ingestion or contact with
skin or eyes. In case of contact, immediately flush affected areas
with water and seek medical attention. Obtain medical attention
immediately for eye contact or ingestion.
3. WARNING: POTENTIAL BIOHAZARDOUS MATERIAL. The
Chemistry calibrator (DR0070) and Urine Chemistry calibrator
(DR0090) are manufactured from materials of human origin. No
test method can offer complete assurance that HIV 1/2, HCV,
Hepatitis B, or other infectious agents are absent from biological
materials, all calibrator material should be handled at the
Biosafety Level 2 as recommended for any infectious human serum
PREPARATION:
The Beckman Coulter AU System Inorganic Phosphorus reagent is liquid,
ready to use. No preparation is needed.
The Beckman Coulter Chemistry Calibrator reconstitution:
Remove the vials of calibrator and diluent from storage and let
stand at room temperature (1525C) for 5 minutes.
Remove the cap and stopper from the vials of the lyophilized serum
and reconstituting diluent.
Using a volumetric pipette or a calibrated airdisplacement
pipettor, add exactly 5.0 mL of reconstituting diluent to DR0070
lyophilized serum vial. DO NOT pour directly from the
reconstituting diluent vial.
Replace the cap and stopper to the vial of lyophilized serum
immediately after adding the diluent
Allow the calibrator to stand for 510 minutes. Gently swirl the
contents until completely dissolved.
The Beckman Coulter Urine Chemistry Calibrator is liquid, ready to use.
No preparation is needed.
Storage Requirements:
1. The unopened reagents are stable until the expiration date printed
on the label when stored at 2 8 °C.
2. Opened reagents are stable for 30 days when stored in the
refrigerated compartment of the analyzer.
3. Contamination after opening must be avoided.
5. For Phosphorus, reconstituted calibrator materials are stable for 7
days from the date of reconstitution when stored at 2 8°C. The
materials should be capped and stored upright 2 8°C when not in
use.
6. Urine Chemistry calibrator is stable until the expiration date
printed on the label when stored at 2 8°C.
7. Once opened vials of Urine Chemistry Calibrator are stable for 30
days.
Indications of Deterioration:
Discoloration of the reagent, visible signs of microbial growth,
turbidity or precipitation in reagent may indicate degradation and
warrant discontinuance of use.
Additional storage requirements as designated by this laboratory:
PERFORMANCE PARAMETERS:
The following data was obtained using this Inorganic Phosphorus Reagent on
Beckman Coulter AU analyzers according to established procedures. Results
obtained at individual facilities may differ.
PRECISION:14
Estimates of precision, based on CLSI recommendations6, are consistent
with typical performance. The within run precision for serum samples is
less than 3%CV and total precision is less than 5%CV. Assays of control
sera were performed and this data reduced following CLSI guidelines.
SERUM
N=100 Within run Total
Mean, mg/dL SD CV% SD CV%
2.01 0.04 1.9 0.04 2.1
5.7 0.03 0.6 0.05 0.9
URINE
N=100 Within run Total
Mean, mg/dL SD CV% SD CV%
METHOD COMPARISON14:
Patient samples were used to compare the Beckman AU System
Inorganic Phosphorous Reagent. Representative performance data on
AU analyzers is shown in the next table.
URINE
Y Method AU640/AU640e
X Method AU600
Slope 0.992
Intercept 0.09
Correlation Coeff. (r) 0.9996
No. of Samples (n) 171
Range (mg/dL) 2.6 – 199.8
Sensitivity:
Typical change in absorbance for 1 mg/dL Inorganic Phosphorus is 30
Absorbance.
CALIBRATION:
STANDARD PREPARATION:
Perform a onepoint calibration (AB) using a water blank (blue rack) and
the appropriate calibrator in a yellow calibration rack. The frequency of
calibration is every 30 days. Calibration of this Inorganic Phosphorus
For Urine calibration: Perform a onepoint calibration (AB), using a water
blank (blue rack) and the appropriate calibrators in a yellow calibration
rack. The frequency of calibration is once in 30 days. Calibration of this
urine procedure is accomplished by use of the Beckman Coulter Urine
Chemistry Calibrator (Cat No DR0090). The assay values for the
constituents of this calibrator are traceable to the National Institute of
Standards and Technology (NIST)
CALIBRATION PROCEDURE:
Recalibration of this test is required when any of these conditions exist:
1. A reagent lot number has changed or there is an observed shift in
control values.
2. Major preventative maintenance was performed on the analyzer.
3. A critical part was replaced.
QUALITY CONTROL:
During operation of the Beckman Coulter AU analyzer at least two levels of
an appropriate quality control material should be tested a minimum of once a
day. In addition, controls should be performed after calibration, with each
new lot of reagents, and after specific maintenance or troubleshooting steps
described in the appropriate AU User’s Guide. Quality control testing should
be performed in accordance with regulatory requirements and each
laboratory’s standard procedure.
Location of controls used at this laboratory.
ANALYZER PARAMETERS:
A complete list of test parameters and operating procedures can be found in
the appropriate User’s Guide and at www.beckmancoulter.com.
CALCULATIONS:
For serum SI units (mmol/L), multiply the results by 0.323.
REPORTING RESULTS:
REFERENCE RANGES:
Serum 12 Urine 8
Beckman Determined Range:13 Serum 3.7 7.2 mg/dL
Expected values may vary with age, sex, diet and geographical location.
Each laboratory should determine its own expected values as dictated by
good laboratory practice.
REPORTING FORMAT:
Results are automatically printed for each sample in mg/dL at 37°C.
Additional reporting information as designated by this laboratory:
LIMITATIONS:
The Beckman Coulter AU System Inorganic Phosphorus procedure is linear
from 1.0 to 20.0 mg/dL for serum determinations and from 10 to 200 mg/dL
for urine determinations. Samples exceeding the upper limit of linearity
should be diluted and repeated. The sample may be diluted, repeated and
multiplied by the dilution factor automatically utilizing the AUTO REPEAT
RUN.
The criteria for no significant interference is recovery within 10% of the
initial value.
Bilirubin: No significant interference up to 40 mg/dL Bilirubin
*Hemolysis: No significant interference up to 350 mg/dL Hemolysate**
**Lipemia: No significant interference up to 900 mg/dL Intralipid*
**Hemolysis must be avoided as Phosphate may be split off from labile
esters in the erythrocytes.10
* Intralipid, manufactured by KabiVitrium Inc., is a 20% IV fat emulsion
used to emulate extremely turbid samples.
The information presented is based on results from Beckman Coulter
studies and is current at the date of publication. Beckman Coulter Inc.,
makes no representation about the completeness or accuracy of results
generated by future studies. For further information on interfering
substances, refer to Young11 for a compilation of reported interferences
with this test.
In very rare cases gammopathy, especially monoclonal IgM
(Waldenstrom’s macroglobulinemia), may cause unreliable results.
Laboratory specific procedure notes:
REFERENCES:
1. Fiske, C.H., Subbarow, Y., J Biol Chem, 66: 375, 1925.
2. Summer, J.B., Science, 100: 413, 1944.
3. Taussky, H.H., Shorr, E., J Biol Chem, 202: 675, 1953.
4. Dryer, R.L., Tammes, A.R. and Routh, J.I., J Biol Chem, 225: 177,
1957.
5. Daly, J.A. and Ertingshausen, G., Clin Chem, 18: 263, 1972.
6. CLSI/NCCLS, Evaluation Protocol EP5A, 1999.
7. Henry, R.J., Cannon, D.C. and Winkleman, J.W., Clinical Chemistry
Principles and Technics, Second Edition, Harper and Row, 1974.
10. Tietz, N.W. (ed), Fundamentals of Clinical Chemistry, Third Edition,
W.B. Saunders, 1987.
13. Beckman Coulter Inc. data on samples collected from 200 blood donors
in North Texas.
14. Data on file for specific AU analyzers.